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G,
The Marcy thing goes beyond mesh vs tissue repair. Even within the small group of surgeons who perform tissue repair, Marcy-like repairs are not used in adult male hernias (Kang is an exception.) If you ask them, most will say the risk of recurrence is too high, and others will say further study is needed before using it that way.
Some Lichtenstein mesh surgeons (like Dr. Chen) do a Marcy in addition to the mesh. The Marcy isn’t considered sufficient by itself.
I’ve always been very curious about this because if Marcy-like repair works well for adult male indirect hernias, why on earth isn’t such a minimal procedure done instead of mesh, Shouldice, Desarda, etc.? It’s the question I find the most perplexing in inguinal hernia repair.